Andy Burnham’s call to abandon “40 years of neoliberalism” rests partly on the damage that he says it has done to northern England. A new study – published in the Lancet this week – adds weight to his argument. It found that for adults aged 25 to 49, death rates in the north were 13% higher than in the south in 1981. By 2024, that gap had more than tripled to 42%. What happened in the four decades that left younger adults in northern England with so much worse chances of survival?
The answer lies in the lives and jobs that people have, and the homes they can afford, as well as the state of the public services, like the NHS, that they rely on. Deindustrialisation stripped secure employment from many communities in the north of England – as it did in Scotland and Wales. Austerity then weakened support systems. These reasons also underscore Mr Burnham’s analysis that Britain’s economic model and concentration of power in London have failed its regions.
The question for the budget is what will it do about these inequalities. The north has substantial levels of deprivation, lower rates of pay and fewer healthy years of life for its people. Among people under 75, the Lancet study found that mortality in northern England was 26% higher than in the south. To close these gaps means helping poorer households with the rising cost of essentials and sending more resources to deprived areas. Investment in, say, early years education and council budgets would help to deal with the social conditions underlying ill health.
Reducing regional inequalities requires redistribution – not just devolution alone. Giving a poorer area more control over an inadequate budget does not increase the cash it can spend. Mr Burnham’s idea to let mayors retain locally raised taxes may help. But without a way to ensure each region gets enough resources to meet their needs, such a policy might simply preserve existing disparities. Researchers at Manchester and Liverpool universities and Health Equity North divided England into two roughly equal populations along a line from the Wash to the Severn Estuary. Closing the north’s health gap, they claim, could add £18bn a year to its economy.
Regional policy plays a complementary role to redistribution by aiming to change where wealth is produced. However, in a recent paper, Steve Fothergill of the Industrial Communities Alliance warned that “the UK has moved away from a long‑established framework that explicitly sought to promote jobs and growth in its less prosperous places … the UK now deploys a weaker set of tools for regional economic development than at any point since the mid-twentieth century”. Mr Burnham needs to reverse this trend.
The chancellor, John Healey, says that he wants a budget for “bloody-minded entrepreneurs”. But a richer northern England would not necessarily be a healthy or more equal one. During the 19th century, when Manchester became known as “Cottonopolis”, Friedrich Engels – bemoaning the city’s “disgraceful unhealthy slums” – was shocked to be told by a local businessman: “And yet there is a great deal of money to be made here.” Bringing investment and good jobs to economically weaker regions matters. But whether the resulting prosperity translates into secure incomes, decent homes, good public services and longer lives is just as important. Mr Burnham’s ambition needs to meet twin challenges: where wealth is created and what life it lets people enjoy.
